ACCURACY OF COMPUTER-ASSISTED DESIGN AND MANUFACTURED (CAD/CAM) THREE-DIMENSIONAL (3D) DEVICE FOR CONDYLAR POSITIONING IN MANDIBULAR BILATERAL SAGITTAL SPLIT OSTEOTOMY (CLINICAL TRIAL)

Abstract

INTRODUCTION: Alignment of dental arches in orthognathic treatment after undergoing Le Fort I osteotomy or bilateral sagittal split osteotomy relies on the use of intermediate and final occlusal splints, which do not provide precise control over the positioning of the condyle and ramus segments. AIM OF THE STUDY: To clinically and radiographically assess the accuracy of CAD/CAM surgical guide for condylar positioning in the bilateral sagittal split osteotomy. MATERIALS AND METHODS: The study recruited eight patients who had non-syndromic dentofacial deformity and underwent Bilateral Sagittal Split Osteotomy (BSSO) with or without maxillary osteotomy. Surgery was planned according to (CAD/CAM) technology. After osteotomy, a preoperative guide was used, followed by a repositioning guide. Computed tomography scans were conducted on all patients one week preoperatively, immediately, and three months postoperatively to assess the condylar position and facial symmetry. RESULTS: The data are presented as median values with the 25th and 75th percentiles. Eight patients (37.50% females and 62.50% males) between the ages of 19 and 24 underwent BSSO with or without LeFort I maxillary advancement. The surgical procedure successfully corrected their skeletal deformities. The absolute change between immediate postoperative and preoperative condylar angle was 0.15 [0.00-0.3]°. The absolute change between three months postoperative and preoperative Condylar Angle was 0.20 [0.00-0.30]°. CONCLUSION: The stability of the condylar head in position and patient postoperative occlusion is well assessed by 3D condylar positioning devices designed and manufactured by CAD/CAM technology in the mandibular BSSO.